Pathological myopia is a major growing public health concern in many countries worldwide including Egypt. Its exact cause is unknown, but multiple genetic and environmental factors are thought to play a role in its pathogenesis. The main concern with pathological myopia from a vitreoretinal perspective is the development of various posterior segment pathologies including tessellation, chorioretinal degeneration, lacquer cracks, posterior staphyloma, myopic choroidal neovascularization, macular holes, myopic foveoschisis, retinal detachment, and peripheral retinal pathologies such as lattice degeneration and snail track degeneration. In this article, we review the different posterior segment manifestations associated with pathological myopia and their morphological and clinical characteristics.